American family physician
-
Gynecomastia may be physiologic, familial, pathologic, drug-induced or, in many cases, of unknown etiology. Breast enlargement is usually unilateral and asymptomatic. ⋯ Treatment of gynecomastia should be directed at the underlying cause when one can be identified. Most cases are benign and can be managed by explanation, reassurance and observation.
-
The increase in major cardiac operations performed in the United States has been accompanied by an increase in the incidence of postpericardiotomy syndrome. Family physicians must be able to recognize the clinical picture, since patients may present several weeks postoperatively. ⋯ Signs include fever, rales, friction rubs, effusions and leukocytosis. Anti-inflammatory drugs are effective.
-
The first-trimester obstetric patient who is experiencing pain or bleeding may have a normal intrauterine pregnancy, a threatened miscarriage, an ectopic pregnancy, a blighted ovum or trophoblastic disease. Correlation of clinical findings, quantitative human chorionic gonadotropin levels and diagnostic ultrasound findings can maximize the efficiency of the work-up, provide a definitive prognosis and identify early ectopic pregnancy.